Provider Demographics
NPI:1114429990
Name:YSASSI, NATLAIE ANN (LVN)
Entity Type:Individual
Prefix:MS
First Name:NATLAIE
Middle Name:ANN
Last Name:YSASSI
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 PARKGREEN DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3214
Mailing Address - Country:US
Mailing Address - Phone:361-510-4611
Mailing Address - Fax:
Practice Address - Street 1:800 N SHORELINE BLVD STE 700S
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-3718
Practice Address - Country:US
Practice Address - Phone:361-937-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329964164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse